Family versus individual therapy for anorexia: impact on family conflict

This study evaluated the impact on family relations of behavioral family systems therapy (BFST) versus ego-oriented individual therapy (EOIT) as treatments for adolescents with anorexia nervosa. Twenty-two adolescents meeting DSM-III-R anorexia nervosa criteria were randomly assigned to receive approximately 16 months of either BFST or EOIT along with a common medical and dietary regimen. BFST emphasized parental control over eating, cognitive restructuring, and problem-solving communication training. EOIT emphasized building ego strength, adolescent autonomy, and insight. Measures including body mass index, self-reported general and eating-related conflict, and observed general and eating-related communication. Both treatments produced significant reductions in negative communication and parent-adolescent conflict, with some differences between condition and between eating and non-eating related measures; the improvements in eating-related conflict were maintained at a 1-year follow-up. The study demonstrated that structured therapies for adolescent anorexia do impact family relations, even when the family is never seen as a unit during the therapy.